Category Archives: HPA axis

… In a number of ways. This article describes a new finding which relates memory loss and cognitive dysfunction to a loss of glutamate receptors in the prefrontal cortex (PFC):body=http%3A%2F%2Fwww.sciencedaily.com%2Freleases%2F2012%2F03%2F120307132202.htm&subject=How+repeated+stress+impairs+memoryThey state that this is why the PFC tends to falter in the face of repeated stress: the receptors for one of the key neurotransmitters become depopulated, leaving fewer sites to accept the glutamate and allow that part of the brain to do its job. Cognitive impairment in the face of repeated or chronic stress is not a monolithic problem, though. Memory and decision-making are probably the most complex of brain tasks, and there are plenty of things that go wrong when memory and cognition fail. Other factors include dopamine depletion, leaving less of that transmitter to carry messages back from the PFC, thereby making executive decisions harder to make and still harder to follow through on. (I wrote a previous post on dopamine and decision making. I’ll dig it up and link over.)And then there’s the adrenaline overproduction and overuse that characterizes chronic and repeated stress, leading to disruption of the hypothalamic-pituitary-adrenal axis (the body’s entire signaling structure for body processes) which contributes to brain dysfunction in still more ways: by disrupting sleep, which disrupts memory formation and impedes logic; and by contributing to the rise of metabolic syndrome, creating less stable blood sugar — which, in the brain, adds considerable insult to injury: a hungry brain is a low-functioning brain. Take your vacations. Simplify your life. Move your body around regularly. Meditate early and often. If you cherish your brain, you might as well let it work — and that means getting a half-Nelson on stress before it gets one on you.

I just went looking for scholarly articles linking chronic CRPS to the HPA axis damage that has been such a feature of my life. Though me, my cohorts and all my providers have been talking freely about this for years, there was nothing on PubMed and nothing of value in the Google search.

It’s possible to chain together articles that make the point — one on stress and adrenal function, one on stress and pituitary dysregulation, one on chronic neurogenic pain and hypothalamic oddness, one on constant pain as a causor of physiologic stress, and one on CRPS as a source of pain — but academics get squirrelly when you make them link the logic. They don’t want to think; it makes them feel exposed.

Nevertheless, me and my providers, me and my cohorts online, me and hundreds and thousands of people with chronic CRPS, have been taking it for granted all this time that there was a link — because it is so bloody obvious that there is.

However, the studies don’t exist.

The connection is obvious, but unwritten.

The data are sitting there, waiting to be captured.

The study subjects are right there for the recruiting.

It’s like the topic is standing there with its pants down and its pockets full. An easy target — and a rich one!

This is ridiculously obvious, and you know that all the subsequent work on CRPS and anything related to the adrenals, hypothalamus and pituitary would have to quote whoever documented it. Tenure, much?

Who wants to find the funding and put together a team? I would be happy to help. If I had the MD and the university contacts, I’d already be making calls. Please, whatever I can do to help, just let me know. Make it happen.

“Standard” treatments don’t work well for me; moreover, they involve invasive procedures too brutal to tolerate and medications I’m either outright allergic to, or that impair me so profoundly I can no longer function. At all.

So I took myself off my meds, thought things over, and came to the following conclusions.

MY CHRONIC PAIN MANIFESTO

Yes, it hurts.It’s going to anyway.

So should I hoard my daysAnd fast from life?Comfort myself with poisons,Blister-packed and FDA approved?

Some think it would be best all ’round.I’d cure them if I could (heh!)But I’m too tired forYet another pointless struggle.

The sunlight pours through trees like proseccoAnd reminds me what it means to live:

Voices warm with love, theMouth-smack of good food,The hug of hills and theRough snuggles of the sea.

Feast on this: The cost of life is much the same. The difference lies in how you spend it.

How is this relevant to medical science? For one thing, it shows just how badly off base it is in vivo. Like any manifesto, it makes an explicit declaration: fundamental attitudes must change.

Policy determines what will be profitable, and profit opportunities determine what science gets funded. There is no profit in fully-functioning people, but there’s plenty in people who are too sick to function but not sick enough to die … for awhile.

Policy could allow my insurance to cover the things that do work (massage, reiki, homeopathy, yoga), especially given the detailed and vivid documentation I’ve provided of just how well they work. Nobody will fund science studies on these in any volume, because it is so much more profitable to drug people into silence.

Do you know why this is, logically, a candidate for the Department of the Blitheringly Obvious?

It has to do with fetal development. In a healthy pregnancy (that is, most of them), labor starts when the fetus’s lungs — the last thing to finish developing — are done. Then the fetus signals the mother’s body, and labor begins.

The neurological system and heart are getting the finishing touches in those last few weeks, too. The final stages of fetal development are extremely important, and ever more so as it gets harder and costlier to get care in this country.

They pop out faster, yes. They also tend to need time in the neonatal ICU.

But wait, there’s more.

This article goes on to say that premature babies tend to have lifelong problems with — you guessed it — heart, lungs, and neurology. Neurological issues that consistently show up relate to coordination; learning (especially math); memory; and, most worryingly, hypothalamic-pituitary adrenal (HPA) axis problems — which messes up the body’s ability to regulate weight, growth, anxiety, sleep, and mood; it’s a major factor in CRPS, MS, and other constitutional illnesses.

These people are far more likely to require extra care and attention from parents, school, doctors, nurses, and therapists of both body and mind, _throughout_their_lives_ — or at least, as Prof. Sullivan has shown, to the age of 21. More data to follow, as the study continues.

This is why I find “elective c-sections”, which are often done at 37 weeks just to avoid the final stage of pregnancy, so appalling. They combine the drawbacks and long-term effects of prematurity with those of nonvaginal delivery and abdominal surgery. A full house, you might say.

Back to this article, which focuses on people who were born 21 years ago, when prematurity was not optional.

She states that these personalities tend to be more driven and success-oriented. On the one hand, that could be the cortisol talking (remember the lack of regulation? These people have higher than normal cortisol levels.) On the other, these are all people who have had a higher than average level of care, attention and structure in their young lives, and that tends to produce these characteristics anyway. When young people internalize the message that there are a lot of capable adults who really care what happens to them, they don’t see failure as anything but learning how not to do it next time. And that’s a setup for success.

Having explicated her stated finding, I have to say that she did not, nor did I read anything here about how she measured these personality characteristics. In short, it’s possible she was looking for ways to make everyone feel better about the learning disabilities and systemic issues.

And that, frankly, is one of the common characteristics of nurse studies that tend to lessen the respect they otherwise deserve: nurses who achieve worldly success don’t get there without being good at making decision-makers feel good.

I looked for the text of the study at her site, but no luck. I’ll look on PubMed once I’m off this handheld. I’d like to clear up that last gratuitous silliness, if I can.

* Can’t find it on PubMed. It was published very recently, so it might be worth checking back.